Comfortably Numb

Hello…hello…hello.
Is there anybody in there?
Just nod if you can hear me.
Is there anyone home?

The world’s gravest public health crisis is unsafe drinking water and inadequate sanitation. Diseases related to this problem kill 5x more kids than HIV/AIDS, and twice as many as malaria. Four billion cases of debilitating diarrhea occur each year, and diarrheal diseases alone kill well over two million kids on an annual basis.

So, the good news: The world came together last week at the Stockholm International Water Institute’s World Water Week to discuss precisely this issue.

And the bad news: the three of you who read this blog are hearing more about World Water Week through this medium than most other people through what I'll humbly call more popular media.

Those mainstream media may well tackle water and climate change, ocean conservation, the bottled water industry, water as a human right, privatization and related issues. But they shy away from unsafe water as the gravest – and most solvable – global public health challenge. This was manifested by the paucity of coverage of World Water Week in at least the U.S. media. Neither The New York Times nor The Washington Post had even a poorly-turned phrase on World Water Week. The only Associated Press story picked up (according to a Google news search) in the U.S. media focused entirely on bio fuels, never even mentioning the severity of this global problem. (Way to go John Sauer at Water Advocates for tracking this.)

Solving the world’s drinking water and sanitation crisis is difficult – it is not a soundbite or silver bullet issue. As my cohort Dennis Warner of Catholic Relief Services says, it’s not rocket science – it’s harder than rocket science. How long did it take to train your kids to wash their hands after they use the bathroom? Do you wash your hands after each trip to the john even today? What’s our water infrastructure financing gap in the U.S. up to now?

But solving this problem is possible. How many English die of cholera in 2007? How many Japanese die of diarrhea? How many Americans have guinea worm, schistosomiasis or malaria?

The unsafe water issue will soon drive the international development agenda itself – it’s unfortunately a matter of time before the media are forced to come to terms with this global challenge whether they like it or not.

I suggest instead that the 1.1 billion people without safe drinking water throughout the developing world need the U.S. and European media to lead the target. As the NYT looks to the FT for story ideas, and as the Economist looks to The New Yorker, one well-placed story on unsafe water as the world’s biggest cause of preventable infant/child mortality and morbidity will punch well above its weight (and win a Pulitzer or two, people).

Some get it: one particularly insightful, clever piece comes from Carl Ganter at the Pacific Institute’s Circle of Blue: Navigating the Mainstream: The Challenge of Making Water Issues Matter. Read it and visit Circle of Blue. Seriously.

Another: Gil Garcetti (yes, that Gil Garcetti) is now an amazing professional photographer covering the world’s water crisis. See his new book Water is Key.

Another: Matt Damon’s new movie Running the Sahara is scheduled for release this fall.

There are stories lined up - there are high profile testimonials lined up – there are convincing water experts lined up. If that’s not enough, there’s always the crushing grip of reason which is tightening. We need to act – there are billions of the world’s poorest waiting for their governments to properly prioritize this issue. There is an opportunity for the Western media to get out ahead of this issue and pull the world along.

None of My Business

Typically, I try always to be open-minded - to walk a mile in the other guy’s shoes, even if it is just to be a mile away and have his shoes when the deal goes sour. However, there are some things to which I cannot possibly relate, and even trying to gets me in trouble. One of those things is the female menstrual cycle.

So I find myself today getting caught up on some reading, in particular a NY Times article from December 23, 2005 entitled “Another School Barrier for African Girls: No Toilet.” I made it about three sentences into the article when this phrase caught my eye: “the realities of menstruation in a school with no latrine, no water, no hope of privacy other than the shadow of a bush, and no girlfriends with whom to commiserate.”

I quickly stopped my halfhearted attempt to relate to this, and am now working on the more simple reality that this is a bad thing and needs fixing.

So… Although the article’s protagonist (Fatimah Bamun, pictured above) is in Ethiopia, this is a reality which unfortunately is not isolated to Ethiopia or even Africa. Fifty percent of the world’s schools do not have access to safe water and single-gender sanitation facilities, and those parts of the world with such luxuries are in the fortunate position of not having to relate to this reality.

In Guinea, enrollment rates for girls from 1997 to 2002 jumped 17 percent after improvements in school sanitation, according to a recent Unicef report. The dropout rate among girls fell by an even bigger percentage.

This post is not about water – it can’t be. This post is about water as a direct conduit to additional educational opportunities for girls, and as a less direct but perhaps more compelling conduit to corresponding increases in economic development and decreases of fecundity rates.

Water and sanitation are statistically validated as significant contributors to education, whether it’s the Education Millennium Development Goal or any other success metric. A recent WaterAid report quantifies the impact of safe water and sanitation on not just the quantity of education, but also on the:

• quality of education - children suffering from diarrhea or thirst (or holding back until nightfall to urinate) cannot concentrate on their lessons, and


• teachers - particularly female teachers who often suffer the same consequences as do their pupils. It is very difficult to recruit and retain qualified teachers where the schools don’t have water and sanitation.

I’d also suggest a quick glance at least at the summary of the Proceedings of the 2005 Water, Sanitation and Hygiene Education for Schools Roundtable Meeting which begins with this quote from former UN Secretary General Kofi Annan:

Water is intimately linked with education and gender equality. Girls who have to spend time gathering water for the family tend not to be in school. And where schools have sanitation, attendance is higher, especially for girls. Water is connected to health, since millions of children get sick and die every year from water-borne diseases and for lack of basic sanitation and hygiene.

I’m not asking readers to relate to this gruesome reality, or even to solve the world’s water problem. More pragmatically I am asking you to consider what it would take to catalyze a situation whereby each of the world’s schools achieves safe, affordable and sustainable access to safe drinking water and single sex sanitation facilities? How many schools are there, how many suffer from these shortages, and what would it take for every government in the developing world to meet its responsibility and fill that gap? Last and least, what could the international donor community do to jumpstart this sort of commitment to life and livelihood?

For example, there are 54,000 schools in South Africa. If 50% of those do not yet have water and sanitation that defines our universe as 27,000 schools. At a conservative (on the high side) $20,000 a pop for water, sanitation and hygiene promotion, that’s $540m. Couldn’t the international donor community come up with $54m to goose the GoSA to make that commitment? Then wouldn’t the governments of Zambia, Mozambique, Botswana and Namibia be embarrassed…

Water, Education, and American Express: priorities...

Just this morning I received an email from an old (I should say long-time) friend of mine suggesting I vote for the DonorsChoose project for education at the Amex Members Project contest here:

Members Project

She positioned DonorsChoose as the "David" and the UNICEF Children's Safe Drinking Water Project as the "Goliath," as does a recent interesting NY Times article here. My response to her (and to the dozens of other friends she had included in her To: line (most always a bad idea) was that Yes, UNICEF is large, but the word"Goliath" unjustly positions the Amex contest as a David vs. Goliath battle which fails to account for the real beneficiaries of both projects: children who either die from unsafe water or do not receive an adequate education.

Unsafe water is the #1 killer of children throughout the developing world. Period. Bad water kills five times as many kids as HIV/AIDS, twice as many as malaria. Period. More germane to this conversation: Without safe water, girl children in particular will not have the opportunity to enroll in school (they spend their childhoods either sick and hauling 45 pound buckets of dirty water on their heads). If their schools do not have single-gender sanitation facilities, they will drop out of school once they start menstruating and lack privacy. Safe water is in many cases the single biggest determinant of whether or not a girl receives an education.

For more information on the water/education nexus:

Water and Sanitation: The Education Drain (WaterAid)

The Education Millennium Development Goal: What Water, Sanitation and Hygiene Can Do

Water, Sanitation and Hygiene Education for Schools - Oxford Roundtable Statement

UNESCO – Focusing Resources on Effective School Health